Creative productions and social media strategy

A recent study finding little difference in the risk of being sued between high quality nursing homes and lousy ones is generating a lot of questions about how to improve quality of care.

The conventional wisdom is that if lawsuits provide a quality-control incentive for providers than lousy nursing homes should be sued far more often than good ones. But when Harvard Medical School researchers sifted through the data they found a weak correlation between quality and litigation.

Among the worst 10 percent of nursing homes they found the risk of litigation ran about 47 percent in a given year. For the best 10 percent of facilities the risk was 40 percent.

Although a seven percent increase is significant, advocates fear it is not nearly enough of an incentive for bad operators to invest the time and money to offer higher quality care.

The reason for the weak correlation is unclear. The researchers went to great lengths to identify the best and worst facilities, using data from the Online Survey, Certification and Reporting system — which covers facility characteristics, staffing ratios and the results of state inspections — and the Minimum Data Set assessing residents’ conditions to determine the best and worse nursing homes. In addition, they convinced five major nursing home chains (for commercial and one non-profit) operating a combined 1,465 nursing homes in 48 states to share information on every claim brought against them over an eight year period.

I’m guessing the data is not detailed enough to estimate the risk of litigation for nursing homes who adopt culture change, but I bet those numbers would be very interesting. Embracing culture change requires allowing for a higher level of risk, which in turn exposes facilities to an increased risk of lawsuits. This would also turn the conventional wisdom on its head.

The important question to ask is what actions can prompt greater commitment to quality care in nursing homes? Consumer education and oversight are important. The past 25 years of tougher federal regulations have made a difference and public reporting quality ratings systems like Medicare’s Nursing Home Compare help direct consumers to better facilities. But advocates say they don’t seem to put enough pressure to turn around the bad apples.

The study’s authors point to a pilot project under way in Arizona, New York and Wisconsin that ties reimbursement to quality measures as a more promising strategy than hiring a lawyer. But it will be several years before the results are in.

What do you think? What role does the culture change movement play in improving the quality of care in nursing homes?

– Frequent escape drills helped save the lives of elders in Japan’s tsunami. [McKnight's LTC News]

– An intentional optimist refuses to be ensnared by preconceptions of aging. [Coloradoan]

Third Age potential and fulfillment can be crushed by outdated ideas about aging. When we believe that growth and life expansion end at a certain time, our minds and bodies respond to and reflect those thoughts.

– Free training available for aging services providers to help improve the quality of services and support offered to lesbian, gay, bisexual and transgender older adults. [Future of Aging]

– What will nursing homes look like when baby boomers need them? [The Green House Project Blog]

– Humor is the best medicine, even for Alzheimer’s. [The Myth of Alzheimer's]

In the wake of new guidelines establishing a “pre-clinical Alzheimer’s”, the video takes on a new satirical resonance:

Our blog post on the best blogs and online resources for Alzheimer’s has generated a lot of great feedback and we’re excited to have some new sites to share with our readers.

Perhaps the most profound website challenging the conventions of Alzheimer’s disease is TheMythofAlzheimers.com — “What you aren’t being told about today’s most dreaded diagnosis.”

TheMythofAlzheimers.com is a web site based on the book written by internationally-acclaimed Alzheimer’s expert Peter Whitehouse, MD, Ph.D, and his co-author, Daniel George, Ph.D., an Assistant Professor at The Penn State College of Medicine.

Both the book and the blog are focused on stripping away the myths and misconceptions about Alzheimer’s and combating the fear, dread and paranoia associated with the disease.

So what are the myths? Whitehouse and George argue that Alzheimer’s is more of a social construct symbolizing our fear of aging than it is a singular disease. It represents our culture’s attempt to make sense of a natural process of aging that has defied the best efforts of modern science and medicine to diagnosis accurately, let alone treat or cure. In fact, they argue that what we call Alzheimer’s is not a singular disease but a complex set of conditions associated with normal aging. Even in an autopsy it is not possible to differentiate the signs of Alzheimer’s disease from normal brain aging.

Their conclusion? The idea that Alzheimer’s is a specific disease that can ever be cured is the biggest myth of all. To “cure” Alzheimer’s we will first have to “cure” aging and death itself. Instead, we need to liberate ourselves from the crippling mental illness label of Alzheimer’s and learn “how to best approach memory loss in ourselves and in others while preserving, and even enhancing, quality of life.”

The Myth of Alzheimer’s is a bold and direct challenge to the multi-billion dollar juggernaut that is the status quo of Alzheimer’s thinking, marketing and research. It’s an alternative approach seeking to humanize the way we think about brain aging and strengthen the care and solidarity provided to people affected by memory loss.

This is what we call “changing aging”.

Below is a brief introduction to The Myth of Alzheimer’s. I highly recommend checking out the site, the book and joining the conversation on their blog.

If you like fashion and you want to benefit from the wisdom of some of the best-dressed elders in the world, you’ll love Ari Seth Cohen’s blog Advanced Fashion.

My name is Ari Seth Cohen the creator of Advanced Style. I roam the streets of New York looking for the most stylish and creative older folks. Respect your elders and let these ladies and gents teach you a thing or two about living life to the fullest. Advanced Style offers proof from the wise and silver-haired set that personal style advances with age.

Check out the latest in Spring colors in this week’s posts and send Seth your pictures of Advanced Fashion to:Advancedstyleinfo@gmail.com

ChangingAging readers — the U.S. Administration on Aging (AoA) needs our help. In honor of Older Americans Month, AoA has launched a social networking initiative aimed at fostering engagement between the generations by way of an online video challenge “Connecting Generations.”

The Video Challenge seeks to bring together multiple generations to create videos featuring the roles elders play in connecting us all. Anyone can participate by joining an intergenerational team—including at least one person age 60 or older and one person younger than 60—to produce a video. They have a cool website featuring the contest here: www.OlderAmericansMonth.org

A panel of judges will select the best video and honor the winner with… (drum roll please) public recognition.

Unfortunately, it appears a grand prize consisting of being featured on AoA’s website has attracted a sum total of ZERO participants, and the May 2 deadline for submissions is only weeks away.

AoA needs our help. This is a great opportunity for ChangingAging advocates to go out and use technology to share perspectives on how older Americans maintain and strengthen connections in our communities. We know there are millions of stories waiting to be told.

AoA has posted detailed instructions on how easy it is to create a quick video and load it on YouTube to enter the contest: http://challenge.gov/AoA/142-connecting-generations-video-challenge

To sweeten the pot, ChangingAging is announcing it will feature ALL entries to the contest on the blog and it will award the winner of the Connecting Generations video project with an HD Flip Camera. This offer is in no way connected to AoA and we hope doesn’t violate any federal rules governing the contest (which is the only reason I can think of they didn’t offer a some kind of prize themselves).

We’ll be checking daily for submissions but please give us a heads up if you participate. Good luck!

A couple years ago ChangingAging and our readers campaigned to challenge the Oprah Show to fully embrace aging in all its beauty, challenges and complexity.

In particular Dr. Bill asked Oprah to find a place on her show for elders and those who care for them to explore a better way of aging.

We asked our community to share their stories about elderhood and caregiving and to appeal to Oprah to give elderhood equal time.

Our community spoke out. We don’t know if Oprah ever heard us, but one of her producers did. In the summer of 2009 she talked to Dr. Bill and she “got it.” When the show’s producers met to discuss guests for the upcoming season she pitched having Dr. Bill on to talk about elderhood.

She got shot down.

Well, it’s been a couple years. Oprah is older. Her audience is older. Yet she still focuses almost exclusively on denying aging.

Our friends at Graceful Aging, the leading video network for older adults, want to make one last appeal to Oprah in the last month of her show. It’s probably a little late to make the Oprah Show, but perhaps in the next phase of her career (and life!) Oprah will look at aging a little more holistically. Here’s a final appeal from Graceful Aging:

Oprah’s last month needs Dr. Bill Thomas and his passion for better elder life as we all age. Dr. Bill Thomas is a driving force changing aging. His deep seated positive spirit and zeal for seniors generates creativity and compassion. Your life will be improved by catching whatever he has, says, and inspires.

Oprah call Dr. Bill Thomas today. Accept aging as beautiful and graceful.

Maryland’s first Green House Project residence is under construction at Stadium Place in Baltimore by Govans Ecumenical Development Corporation (GEDCO). If you missed yesterday’s post from the Green House Project Blog, there’s an excellent video featuring GEDCO and other great organizations in Baltimore supporting community-based revitalization.

I’m lucky to live a few blocks away from Stadium Place and stopped by yesterday to talk to the GEDCO team about featuring their blog Aging in Baltimore on the upcoming ChangingAging Blogstream. GEDCO has a focus on providing affordable housing and services with over 50 member organizations consisting of churches, community groups, schools and service organizations in north Baltimore.

The Green House Residences at Stadium Place will provide affordable residential care for frail older adults who need skilled nursing and long term care. Before leaving I got a tour of the construction site from GEDCO’s director Mitch Posner:

 

Dr. Al Power (ChangingAging’s resident dementia expert) and I have been trying to put together a list of the best blogs and web resources focused on Alzheimer’s and dementia. We want to make sure we connect with those sites on the ChangingAging Blogstream when it goes live.

Today I want to feature the Alzheimer’s Association, which I think is the best resource on the web for information and advocacy around Alzheimer’s disease. We recently blogged about their 2011 Alzheimer’s report on the massive cost associated with caring for people living Alzheimer’s.

A main goal of the Alzheimer’s Association is to raise awareness of the disease and to advocate for increased research on treatments and cures (Out of the top 10 causes of death, Alzheimer’s ranks sixth and is the only cause of death without a treatment or cure). In the recent report “Generation Alzheimer’s: The Defining Disease of the Baby Boomers”, the association asks bluntly “Where is the treatment, where is the cure?”:

The National Institutes of Health spends over $6 billion a year on cancer research, over $4 billion on heart disease research and over $3 billion on HIV/AIDS research. But it spends only $480 million on Alzheimer research.

The association put together an Alzheimer’s News micro-site featuring facts and figures, videos and social networking tools to help advocates spread the word.

You can also stay up-to-date on the latest news their blog Alz.org.

Below, in no particular order, are the other top Alzheimer’s-related blogs that I follow in my Google Reader. Please let me know what I’m missing in the comments section.

Alzheimer’s Support

Alzheimer’s Speaks Blog

Alzheimer’s Reading Room

Mayo Clinic Alzheimer’s Blog

Dealing with Alzheimer’s Blog

From the Mind of Richard Taylor

Early Onset Blog

The Tangled Neuron

 

The latest from the Picker Report on Aging’s RealCareNowTV:

Picker Institute and Planetree teamed up in 2010 to produce the Long-Term Care (LTC) Improvement Guide, a roadmap for nursing home, assisted living facilities and other organizations adopting patient-centered care reforms.

Planetree and the Picker Institute are two of the leading nonprofit organizations working to advance patient-centered reforms across the healthcare continuum. Drawing on the expertise of dozens of advocates and thought-leaders, the 296-page guide provides a complete blueprint and assessment tools for improving patient and resident-centered care.

Dr. Bill Thomas is joined by Heidi Gil of Planetree to discuss how to use the LTC Improvement Guide to advance patient-centered care:

The guide contains three parts:

• Part One – Making the Case for Change
• Part Two – Building a Community – A Process for Transformation
• Part Three – Practical Approaches for Building A Resident Centered Culture

Download the Long-Term Care Improvement Guide

The Picker Institute builds on eight Principles of Patient-Centered Care:

1. Respect for patients’ values, preferences and expressed needs
2. Coordination and integration of care
3. Information communication and education
4. Physical comfort
5. Emotional support and alleviation of fear and anxiety
6. Involvement of family and friends
7. Continuity and transition
8. Access to Care

The guide contains professional resources and links to even more resources. Download it here.